Avtor/Urednik		Šeruga, Tomaž
Naslov		Perkutana transluminalna angioplastika vertebralne arterije v zdravljenju vertebrobazilarne insuficience
Prevedeni naslov		Percutaneous transluminal angioplasty in therapy of vertebrobasilar insufficiency
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 68, št. 3
Leto izdaje		1999
Obseg		str. 161-3
Jezik		slo
Abstrakt		Background and methods. Percutaneous transluminal angioplasty (PTA) in atherosclerotic occlusive disease is nowadays treatment of choice in peripheral circulation. This method is not so commonly used in therapy of supraaortic arteries because of the potential risk of complication like microembolization of the posterior cerebral circulation. Diagnostic angiography of vertebral artery can be of a significant risk, especialy in a simptomatic patient, that already had recurrent transient ishemic atack and stroke. Spiral CT angiography of vertebral artery was performed and there was a 2.5 cm long 90% vertebral artery stenosis at the origin of the right vertebral artery. On CT scan the stenosis was relatively smooth and of homogenous densitiy. Left sided vertebral artery was hipoplastic but without a stenosis. Results. DSA angiography was performed to confirm the CTA finding. We decided to do the angioplasty. There were no complications in form of embolic episodes and no neurological deficits due to brain ishemia during the short time of the baloon inflation. The patient did well and subsequently thare was a significant improvement in his neurological status. Conclusions. Successful PTA of vertebral artery can significantly improve hemodynamic conditions of the posterior circulation and abolish the symptoms of vertebrobasilar insufficiency.
Izvleček		Izhodišča in metode. Perkutana transluminalna angioplastika je danes najprimernejša terapija pri zdravljenju aterosklerotične okluzivne bolezni periferne cirkulacije. Pri zdravljenju stenoz supraaortalnega ožilja se ta metoda redkeje uporablja, saj mikroembolija v vertebrobazilarni cirkulaciji povzroča večje poslabšanje bolnikovega zdravstvenega stanja kot embolija v perifernem obtoku. Do takšnih zapletov lahko pride že pri običajni diagnostični angiografiji vertebralne arterije. Pri bolniku, ki je imel več inzultov v malih možganih v povirju arterije cerebri posterior, smo naredili angiografijo s pomočjo spiralne računalniške tomografije in odkrili 2,5 cm dolgo, 90% zožitev začetnega dela desne dominantne vertebralne arterije. CT je pokazal gladko in strukturno homogeno stenozo. Desna vertebralna arterija je bila hipoplastična, vendar brez stenoz. Rezultati. Naredili smo angiografijo leve vertebralne arterije, ki je potrdila angiografski izvid računalniške tomografije. Odločili smo se za angioplastijo stenoze. Ob posegu ni bilo zapletov v smislu mikroembolizmov ali nevroloških izpadov zaradi kratkotrajne ishemije med dilatiranjem balona. Bolnik med samim posegom ni imel težav, njegovo klinično stanje se je po posegu zelo izboljšalo, nevrološki izpadi so delno regredirali. Zaključki. Uspešna PTA vertebralne arterije lahko bistveno izboljša hemodinamske razmere v posteriorni cirkulaciji in s tem delno tudi odpravi simptome vertebrobazilarne insuficience.
Deskriptorji		ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY ARTERIAL OCCLUSIVE DISEASES VERTEBRAL ARTERY ANGIOGRAPHY CEREBROVASCULAR DISORDERS CEREBROVASCULAR CIRCULATION